Adrenal Dysfunction/ Adrenal Medulla Flashcards
Primary Adrenocortical Insufficiency (Addison Disease) is characterized by what
defect within adrenal gland
Primary Adrenocortical Insufficiency (Addison Disease) is cased by what
destruction of gland by tuberculosis, metastatic tumor
an autoimmune disorder
inborn errors of steroid hormone synthesis
Clinical Features of Primary Adrenocortical Insufficiency (Addison Disease) are
aldosterone deficiency
cortisol deficiency
androgen deficiency
consequences of aldosterone deficiency are
decreased renal absorption of Na+ (hyponatremia and polyuria)
extracellular fluid depletion (reduced plasma volume, hypotension, dehydration)
hyperkalemia
consequences of cortisol deficiency
inability to handle stress hypoglycemia when stressed or fasting weakness and fatigue hypotension decreased appetite and weight loss anemia hyperpigmentation GI discomfort, nausea and occasional vomiting
consequences of androgen deficiency
loss of pub and axillary hair in females
Secondary Adrenocortical Insufficiency is associated with what
insufficient production of ACTH
insufficient production of renin
clinical supraphysiological doses of synthetic glucocorticoids cause what (and how)
Secondary Adrenocortical Insufficiency associated with ACTH
surpasses the hypothalamic-pituitary axis and depression of ACTH leads to adrenal atrophy
pseudohypoaldosteronism is cased by what
loss of function mutant in the mineralocorticoid receptor
pseudohypoaldosteronism is characterized by what
severe salt wasting in neonate
hyperkalemia
metabolic acidosis
failure to respond to treatment with mineralocorticoids
cushing syndrome is characterized by what
excessive cortisol secretion
major causes of cushing syndrome are?
injection of pharmacological doses of glucocorticoids
excessive secretion of ACTH by pituitary (Cushing’s Disease)
ectopic, non-endocrine, ACTH secreting tumors
tumors of adrenal cortex
patients with cushing syndrome have what clinical facial feature
moon face with acne
clinical features of cushing syndrome are?
obesity hypertension glucose intolerance hirsutism amenorrhea purple cutaneous striae bruise easy osteoporosis acne poor wound healing mental effects
what are the mental effects related to cushings
personality changes
insomnia
depression
poor wound healing seen in bushings is due to the inhibitor effects of cortisol on what
production of mediators of inflammation production of chemotaxic and mitogenic mediators fibroblast proliferation collagen biosynthesis circulating levels of WBCs
Primary aldosteronism (Conn Syndrome) is caused by what?
autonomous secretion of aldosterone, usually by ademona arising from zona glomerulosa
Primary aldosteronism (Conn Syndrome) symtoms are
mild hypertension
hypokalemia
metabolic alkalosis
low plasma renin
in patients with conn syndrome plasma renin levels are what?
depressed (as a result of expanded extracellular volume)
secondary aldosteronism is cased by what
inappropriate activation of renin-angiotensin system
Congenital Adrenal Hyperplasia (CAH) refers to what
group of genetically transmitted enzymatic deficiencies in the biosynthesis pathway for adrenal steroids
hyperplasia results when?
deficiency in biosynthetic pathway for cortisol
deficiency in biosynthetic pathway for cortisol result in what
decrease in negative feedback inhibition resulting in rise in ACTH secretion
what actually induces the hyperplasia of the adrenal gland
tropic effect of ACTH
in hyperplasia there is a build up of what
steroid intermediates directly behind the enzymatic block
